Vilma Hänninen

Social support, life events and psychosomatic symptoms among 14-16-year-old adolescents

The role of family, friends and confidants in mediating the impact of adverse life events on psychosomatic symptoms in mid-adolescence was studied. School children (n = 2013) completed questionnaires in class on three occasions during 17 months. Data about social support and life events for 12 months were gathered retrospectively in the final questionnaire. The differences in symptoms by life events and social support were already present at the beginning of the study. Those adolescents who had experienced adverse life events and reported a poor relationship with one or both parents had the highest levels of symptoms and the greatest increase in symptoms during the follow-up. Lack of friends was also associated with psychosomatic symptoms, especially among those who had experienced adverse life events. The results suggest that adolescents who lack parental or peer support are at risk for psychosomatic symptoms in general, and especially in the face of stressful life events.

Sex differences in coping and depression among young adults.

The main purpose of the study was to evaluate the notion that the association between sex and depression is partly mediated by differences in coping styles. The study is based on questionnaire data from 890 female and 766 male Finnish 22-year-old young adults. Of the 12 ways of coping presented, self-blame, venting anger on others, seeking comfort in sweets and drinking beer were positively, and the others negatively, associated with depression; these were called dysfunctional and functional ways of coping, respectively. Women resorted much more often than men to dysfunctional ways of coping, except drinking. They also scored lower on personal resilience and showed more depressive symptoms. The sex difference in depressiveness was eliminated when dysfunctional coping was taken into account.

Getting a Better Job: Antecedents and Effects

The effect of improvement of working conditions on symptoms of mental distress was examined in a longitudinal study of metal industry employees. The aim was to investigate the changes in working conditions, job satisfaction, and indices of mental health among the employees who were promoted or changed employer compared to those who had stayed in the same job during the 5-year follow-up period. Results show that work content and physical work environment had significantly improved in the job change groups compared to the control group. Job dissatisfaction, life dissatisfaction, and stress symptoms had decreased significantly in the job change groups only among the male blue-collar workers. The most powerful predictors of changes in job stress and general distress were changes in work content and changes in the quality of physical work environment. The multiple correlations obtained in the regression analyses ranged between 0.29-0.36.

Narratives of masculinity and depression

Positioning oneself in relation to hegemonic masculinity can be seen as a pervasive aspect of a man’s actions and experiences. In this study, the connection between masculinity and depression was studied using a sample of Finnish men in their forties, who had self-identified as depressed. Interviews of twenty-four men were analyzed using narrative methods. We found four main ways in which men’s depression was related to masculinity. Depression could be seen as a consequence of both realized and unattained hegemonic masculinity. Moreover, some men challenged the hegemonic masculinity and located the cause of their depression within the sociocultural gender order. Ways of thinking and acting that are traditionally held as masculine could also serve as a resource to cope with one’s mental distress. The findings show that the concept of masculinity is useful in understanding men’s depression, but there is no single kind of association between masculinity and depression.

Outcomes of psychotherapy from the perspective of the users.

Abstract Psychotherapy is widely held to be an effective means to decrease depression. It seems, however, that not everyone benefits from every kind of therapy, and the relevant outcomes vary from person to person. In this article, the pre-therapy views and post-therapy experiences of 14 users of either long-term psychodynamic psychotherapy or short-term solution-focused therapy are analyzed. The interviewees’ personal views about their depression and therapy are approached with the concept of inner narrative. Three “basic stories” or orientations were found: life historical, situational and moral. These offered people different contexts from which to evaluate the outcomes of their therapy. The findings suggest that a persons expectations, hopes and values are worth taking into account to ensure positive therapy outcomes.

Life events or life processes as determinants of mental strain? A 5-year follow-up study☆

In a study among Finnish metal industry employees (n = 748) mental strain was measured at the beginning and at the end of a 5-year follow-up. Life event data for the follow-up period were gathered retrospectively through a questionnaire and a later interview. Mental strain was substantially higher among blue-collar than white-collar workers. In contrast, no differences in the occurrence or in the rating of life events was observed between these groups. Self-rated undesirable events were associated with high levels and desirable events with low levels of mental strain. Similar associations were observed in three objectively defined live events, viz. divorce, promotion in the job and change in housing conditions. Life events were, however, also related with the mental strain measured prior to the life events. Both the self-rated and objectively defined desirable events had usually a favourable impact on mental well-being, whereas undesirable events in most cases slightly increased mental strain. The differences in mental strain between occupational status groups seem to be caused by differences in the life processes rather than life events. Furthermore, many life events, e.g. divorce, are actually only discrete moments in long-lasting processes, which have an impact on mental well-being. And last, desirable life events can be seen rather as a preventive than a risk factor of mental strain.

Young people's narratives of depression

This article reports on findings from a study, which aimed to gain insight into young peoples depression as a part of their life course by analysing written accounts of 81 young Finnish people who self-identified as having been depressed. The participants’ accounts were seen as reflecting both their actual life and their narrative interpretations of it in relation to the prevailing normative conceptions regarding youth. The accounts can be grouped into four main story types. The story type referred to as growing up on a sidetrack depicts depression as having its origins in childhood adversities that hinder the realisation of normative goals. Falling off the track depicts how a young persons life can be derailed as a result of experiences that cause or exacerbate depression. In the story missing the track, depression is intertwined with ones experience of failure in meeting normative expectations, whereas the story questioning the track features the problematisation of such expectations. The results underscore the importance of tackling different adverse conditions in childhood, adolescence and young adulthood in a timely fashion, as well as the importance of therapy, counselling and guidance, which help young people to manage difficulties and depression in their life.

Disclosure of Type 1 diabetes at work among Finnish workers.

To determine which self‐management factors and psychosocial work factors were associated with disclosing diabetes to colleagues, line managers and occupational health personnel among workers with Type 1 diabetes.

Work ability among Finnish workers with type 1 diabetes

BACKGROUND Work ability represents the balance between individual resources, health status and job demands. As far as we are aware, these issues have not been examined in working people with type 1 diabetes (T1D). AIMS To examine how work-related and diabetes-related factors are associated with work ability among male and female workers. METHODS Questionnaires were mailed to a random sample of 2500 people with T1D from the Medication Reimbursement Register of The Social Insurance Institution of Finland. The associations of the predictors of poor work ability were examined in a logistic regression analysis. RESULTS The final sample comprised 767 working people aged 18-64 with T1D; overall response rate 49%. One in every three working men and women with T1D had poor work ability. High job demands and low job control were associated with poor work ability in both genders. Physical work and low worktime control were significantly associated with poor work ability in men but not in women with T1D. A self-reported high value of glycosylated haemoglobin was the only diabetes-related variable associated with poor work ability in both men and women. CONCLUSIONS Work-related factors and poor glycaemic control were associated with poor work ability in individuals with T1D. Thus, job control and worktime control should be taken into account in supporting the work ability of workers with T1D.

Concealment of type 1 diabetes at work in Finland: a mixed-method study

Objectives To explore the possible reasons for concealing type 1 diabetes (T1D) at work. Methods The main set of data came from a cross-sectional survey (response rate 49.3%), the participants of which were 688 wage earners with T1D. Concealment of T1D was measured by asking respondents have they ever during their working career hidden their diabetes from their (A) colleagues and (B) line manager. Furthermore, semistructured interviews (n=20) were conducted to obtain deeper understanding. Questionnaire data were analysed using logistic regression analyses and qualitative interviews with inductive thematic analysis. Results About 30% of wage earners with T1D had concealed their condition during their working career from their colleagues and almost 20% from their line manager. Individuals aged 18–44 years age were more likely to conceal their T1D from their colleagues than older workers during their working career. Not disclosing T1D to the extended family (OR 5.24 (95% CI 2.06 to 13.35)), feeling an outsider at work (OR 2.47 (95% CI 1.58 to 3.84)), being embarrassed by receiving special attention at work (OR 1.99 (95% CI 1.33 to 2.96)) and neglecting treatment at work (OR 1.59 (95% CI 1.01 to 2.48)) were all associated with concealment of T1D from colleagues. The youngest age group of 18–24 years were more likely to conceal their T1D from their line managers than the older age groups during their working career. Not disclosing T1D to the extended family (OR 4.41 (95% CI 1.72 to 11.32)), feeling like an outsider at work (OR 2.51 (1.52 to 4.14)) and being embarrassed by receiving special attention at work (OR 1.81 (95% CI 1.13 to 2.91)) were associated with concealment of T1D from line managers. From the interviews, five main themes related to concealment emerged, expressing fears related to the consequences of telling: (1) being perceived as weak, (2) job discrimination, (3) unwanted attention, (4) being seen as a person who uses their T1D for seeking advantages and (5) losing privacy. Conclusions A considerable proportion of wage earners with T1D are concealing their diagnosis often because of feelings associated with stigma. Both overemphasis and underestimation of T1D at work by the colleagues or line manager may lead to concealing T1D and may thus be harmful to self-management of T1D. The obstacles in disclosing T1D might be diminished by giving adequate information at the workplace about the condition and its significance.